Tuesday, June 17, 2008

Lumpectomy was performed June 11th by my surgical oncologist, Dr. Michelle Specht. Adding cruel insult to injury, Colin and I were required to check in at 6:00 a.m. for a 11:15 a.m. scheduled surgery. This followed a hot night in which we slept with the windows open for some breeze, and our stoopid neighbor decided to set off fireworks at 11:00 p.m. Naturally Sarah woke up and cried off and on for the next hour, requiring me to go into her room about 20 times. Plus I couldn’t eat or drink after midnight, so I arrived having a head start on being tired, hungry, and grumpy which would only worsen over the course of the morning.

The first event after check-in and changing into a hospital gown was a lengthy disagreement over whether they would use my port or place a new IV line. I insisted to the day surgery nurse that I wanted them to access my port and use that for any IVs. First she said that the anesthesiologist wouldn’t want to use the port (out of fear it would get ruined – huh?). Then after talking to a few people, she changed her story to say that since I needed to get a mammogram after having the line placed, the people in radiology told her we couldn’t use the port (which is on the upper right side chest) because it could get in the way of the machines. I gave in and let them put in an IV in my hand, but made it clear I was very unhappy about this. Since I was being a difficult patient, at least they called in an anesthesiologist to do it, and he did a beautiful job. As opposed to the other nurses who’ve tried IVs on me, he took 4 extra steps: first he warmed my had on a bag of heated saline solution, then he put the rubber tourniquet around my wrist instead of the usual arm location, he injected me with Lidocaine first (ow, but less so than otherwise), and finally choose a smaller than normal needle for the job. If they ever talk me out of my port again, I’m demanding this luxury treatment!

Next came the worst part of the day. I was sent via wheelchair (hospital rules) to radiology to have wires placed on either end of Chucky so the surgeon knows exactly where he begins and ends to aid in removing it entirely. On smaller tumors they may put one needle right in the middle of the cancer, but on my last MRI they had spotted some calcifications next to Chucky that “are probably nothing, but we’ll take them out too just to be sure.” Picture this: I am in the mammogram machine, undergoing “compression,” in other words with a squished flat left boob and no way to escape, and then they start poking more needles into me! The doc put in some Lidocaine, followed by a needle with a wire inside it. But the wire part hurt so much I began to cry so she gave me more Lidocaine. Now, why wouldn’t she just give me a crapload (this is a technical term meaning “lots”) of Lidocaine in the first place, just in case? So then I was miserable and scared and in pain, but wanted to get it all over with so we continued. She poked the two needles in – way way in – and then went and took a picture to see where they were inside my breast. Then she came back to me, jiggled the wires around a little bit, and took a picture again. Repeat about 6 times until she had them exactly where they were supposed to be. After about 20 minutes in the machine I was finally released. At the end of all this, I asked the nurse who was still in the room why my port couldn’t be used for my IV, since that part of my body was really not near the mammogram machine after all. She said, “oh, it would be fine to use your port, we have people come down here with them accessed all the time. Who told you it couldn’t be used?” This injustice set me off again so I was wheeled out to a waiting Colin all weepy and undoubtedly scared everyone in the waiting room.

Back upstairs to day surgery, where we had to let the wires sit for 2 hours before we could do the surgery, I’m not exactly sure why (maybe it’s like Jello). I read my Janet Evanovich novel which nicely fit the escapism bill. Dr. Specht came to talk to me about the surgery and warned me that there was about a 20% chance with this procedure that we wouldn’t achieve clean margins, which means that when the tissue is looked at under the microscope afterwards, they find that the tumor reaches the edge of the tissue, which means some of it could still be left in the body and they have to try again. Finally another anesthesiologist arrived to ask me what kind of sedation I wanted for the surgery – something that would let me be awake and talking while it was going on, or something that would knock me out entirely. He didn’t even get the question out of his mouth before I said “I don’t want to know or feel a thing!” Really, who would? Especially after the horrors with the wires. I was wheeled into the OR, given a mask, and woke up about 2 hours later, groggy with a chunk of missing breast.

Colin took me home and I napped the rest of the afternoon. He stayed home with me for 2 more days, and though I was sore, I wore a sports bra 24-7 and took lots of painkillers so I was capable of getting around and we even went to movies during the day, a rare treat (“Zohan” – good, “The Happening” – didn’t). When the weekend rolled around each kid managed to bump me on the surgery breast at least once, which was mighty painful.

RESULTS Now, just as I’ve been on the mend, Dr. Specht called this evening. The pathology results are back on the tissue they removed from my body. The good news – there was dead cancer in there, showing that the chemo was working. The less good news – there were also live cancer cells, which we’d prefer not to see. Also the tumor was 4 cm across, larger than the 2.5 cm we thought it had shrunk to. The rotten news – while there were clean margins on almost the whole thing, there was one little spot of dirty margin. Therefore I am going back to the hospital next Tuesday to do this all over again. At least we get to skip the wire thing next time.

we are thinking about you over here and still dealing with crisis on our end ( more on that when we see you sometime in July ) nothing medical anyhow.both kids now off ( that's good)I am glad it's almost over for you visa vie the surgery and my intention is that after next week it's only up hill from here.more lasagnas coming after 7/4. I am off till then.need ethan to come and go thru the yard toys in my basement. sorry we have been so scarce.... but our thoughts are with you.love hetty and chris.